Infectious diseases Guide for general practitioners. Rakhmanova A.G.

Publishing house "Peter" 2001

The second edition of the reference manual (the previous one was published in 1995) provides in detail basic information about the etiology, epidemiology, clinical picture of infections that have an epidemic nature of distribution, severe complicated course (HIV infection, influenza, diphtheria, viral hepatitis, etc.), and also about diseases that are not well known to a wide range of doctors (hemorrhagic fevers, Lyme disease, campylobacteriosis and helicobacteriosis, chlamydial and mycoplasma infections, etc.). Particular attention is paid to early diagnosis, first aid, outpatient treatment, and medical examination. In preparing the guidelines, the authors used many years of experience in clinical and teaching practice, as well as the results of scientific research.

The guide is intended for general practitioners (GPs), infectious disease specialists, epidemiologists, as well as practitioners in many other specialties.
Preface

The reform of the domestic healthcare system involves bringing medical care closer to the patient at the prehospital stage. The huge number of clinics built in past years and thousands of trained doctors and nurses have not significantly improved the quality of diagnosis and treatment. The local therapist, who has a heavy workload and does not have a modern material and technical base, has turned into a dispatcher, referring the patient either to “narrow” specialists or to hospitalization. The doctor shared responsibility for the patient with many specialists, as a result of which his qualifications decreased, professional interest and prestige fell.

This became especially unacceptable during the period of healthcare reorganization and the introduction of compulsory health insurance, primarily in St. Petersburg and Moscow.

The developed health care restructuring program takes into account the entire complex of conditions of existence of an individual, family, team, and society. It covers all factors influencing the health of the population: the contribution of healthcare and medicine (8.5-10%), lifestyle (50%), heredity (20%), and the state of the environment (20%). In this regard, there is a need to change the role of the local therapist in the healthcare system.

We came to the conclusion that the prototype of the new generation of doctors should be the medical worker who existed in Russia in pre-revolutionary times, who was the prototype of the literary heroes of A.P. Chekhov - the zemstvo doctor. This conclusion is confirmed by extensive foreign experience.

In reality, general practitioners and nurses will appear in their workplaces in a few years, since their serious training is required. But training of medical workers according to specially developed programs has already begun. These programs pay special attention not only to pathology, but also to prevention.

Infectious diseases, as in previous years, continue to occupy one of the leading places among human diseases. The problems of viral hepatitis and acute intestinal infections remain relevant. Long-forgotten diphtheria has returned from past years, new infections caused by herpes viruses, Borrelia, chlamydia, etc. have become widespread, and AIDS poses a threat to humanity. In the context of socio-economic changes, which led to the stratification of society and the emergence of a large number of socially unprotected people, many infectious diseases became severe, often fatal.

Modern advances in virology, immunology, and applied pharmacology have allowed infectious disease specialists to reconsider their views on the etiology and pathogenesis of many diseases and achieve certain successes in treatment.

However, the idea that infectious diseases should be known primarily by infectious disease specialists is incorrect. General practitioners are the first to see infectious patients. It is on their qualifications that the early recognition of infection, the determination of the correct therapeutic tactics, the organization of anti-epidemic measures, and ultimately the fate of the patient and the well-being of the people around him depend. This is confirmed by the high daily mortality rate in infectious diseases hospitals, reaching 30% of all deceased patients.

The authors considered it necessary to consolidate the syndromic approach to diseases with a detailed description of nosological forms, especially those that have now acquired epidemiological significance, received a new interpretation, or are little known to a wide range of clinicians.

Modern data on the structure of viral hepatitis, herpesvirus, HIV infections, Lyme disease, diphtheria, Flexner's dysentery will help general practitioners solve specific clinical problems.

"Moscow Week" (later "Moscow Weekly"). He founded the Scientific Word publishing house, with which V. O. Klyuchevsky, I. I. Mechnikov, and P. P. Muratov collaborated.

In the Rakhmanov family prayer room there was a large collection of ancient icons, which Pavel Muratov studied at the invitation of Georgy Karpovich. Muratov also used Rakhmanov’s connections in the Old Believer environment to travel to Old Believer monasteries for the purpose of studying icon painting. Nowadays, many museums have icons known as “Rakhmanov’s”.

Literature

• P. Muratov. Stroganov school. (With I. E. Grabar History of Russian Art In 5 volumes, 1909-1917.)

see also

• Sergei Ustinovich Solovyov, architect of the Rakhmanov family charitable foundations

Wikimedia Foundation.

2010.

See what "Rakhmanov G." is in other dictionaries:

Rakhmanov is a surname common among Russians, mountain Jews and Muslim peoples of the former USSR. Famous bearers: Rakhmanov, Alexander Andreevich (b. 1989) international chess grandmaster, member of the Russian National Team. Rakhmanov, ... ... Wikipedia RAKHMANOV - Alexander Nikolaevich (1861 1926), a famous obstetrician, a great public worker in the field of maternal and infant health. Upon completion of Moscow. University (1885) first worked at the Slavyansky clinic, then completed his residency (1886-1889) in... ...

Great Medical Encyclopedia - (Rakhmanov, PE) in Triodion, Chernigov, 1685, on an engraving (on wood): Christ crucified among the thieves (98 l.), below his signature: “PE RAKHMA.” (Rovinsky) Rakhmanov, P. wood engraver; 1629 and 1685 (Polovtsov) ...

Large biographical encyclopedia - (Rakhmanov Sokolov) Nikolai Nikolaevich (XI 22 (XII 4) 1892, Odessa XI 13 1964, Moscow) owls. composer and conductor. In 1908 11 studied music. school of the Russian Musical Society, in 1917 he graduated from A. Shor’s music courses in Moscow in the classes of phonography, theory and conducting; took... ...

Music Encyclopedia

RAKHMANINOV RAKHMANOV ROKHMANINOV ROKHMANOV TYULENIN RAKHMANIN 1. The word Rakhmanin has different, extremely diverse meanings in different dialects: lethargic, frail, cheerful, plump, handsome, smug, etc. 2. Also, these surnames often come from ... Russian surnames

Georgy Karpovich Rakhmanov (1873 1931) Russian public figure, publisher, professor at Moscow University. Comes from the Old Believer merchant family of the Rakhmanovs. Published the weekly social and political newspaper “Moscow... ... Wikipedia Rakhmanov - nickname...

Spelling dictionary of Ukrainian language- RAKHMONOV Alexander Nikolaevich (1861-1926), obstetrician, organizer of obstetrics. Organized and headed a free maternity hospital (1889), developed a project for a model maternity hospital named after. A.A. Abrikosova (built in 1906) in Moscow, for the first time in... ... Biographical Dictionary

Rakhmanov Nikolai (1932, Moscow) is a recognized classic of Soviet photography, photojournalist. Contents 1 Biography 2 Sources 3 Literature 4 Links // ... Wikipedia

- (composer) (Rakhmanov Sokolov) (1892 1964) Soviet composer and conductor Rakhmanov, Nikolai Nikolaevich (photographer) (1932) photographer, photojournalist ... Wikipedia

Books

• Leonid Rakhmanov. Favorites. Stories from different years, Leonid Rakhmanov. The one-volume book of the famous Soviet writer and playwright L. N. Rakhmanov included his story “Bazil”, dramatic works “The Hermit of Down”, “Restless Old Age”, “The Stone Throwed at ...
• Decorative mice and rats. Maintenance, breeding, taming, disease prevention, Rakhmanov A.I.. The book describes various types of rats and mice that are kept at home as ornamental animals. Advice is given on keeping, taming, caring for and breeding these funny…

On November 18, 2015, at the age of 84, Doctor of Medical Sciences, Professor, Chief Infectious Diseasesist of the Health Committee of St. Petersburg, Deputy Chief Physician of the AIDS Center, Honorary Doctor of the St. Petersburg MAPO, Honored Scientist of the Russian Federation, died from a long illness.

RAKHMANOVA AZA GASANOVNA

Professor Aza Gasanovna Rakhmanova was a major and recognized scientist in the field of medicine.

Aza Hasanovna came to work in the healthcare system in 1958. Starting from the first steps of her career, she went through a long creative and scientific path from a graduate student to the chief infectious disease specialist of the St. Petersburg Health Committee.

Under the leadership of Rakhmanova A.G. 16 doctoral and 55 candidate dissertations were defended. Students of Rakhmanova A.G. operate in all regions of Russia, CIS countries, USA, Canada, Germany, Finland.

For her conscientious long-term work and personal contribution to the development of healthcare in the Russian Federation and St. Petersburg, Aza Gasanovna Rakhmanova was awarded with incentives and awards: Certificates of Honor from the Health Committee, the insignia “For Services to St. Petersburg”, Gratitude from the Minister of Health of the Russian Federation, the “Excellence” badge healthcare", medal of the Order "For Merit to the Fatherland" 2nd degree, medal "Veteran of Labor".

We mourn the death Rakhmanova Azy Hasanovna and express our condolences to family and friends.

AIDS Center team

Doctor of Medical Sciences, Professor, Honored Scientist of the Russian Federation Azu Gasanovna Rakhmanova, born into a medical family, thanks to her talent, hard work, love for people and desire to be modern, achieved great success in science and clinical medicine. Arriving in Leningrad and entering the 1st Medical Institute at the Faculty of Medicine, she immediately became a leader among the students. Her leadership ability lasted throughout her professional career. She was a leader among clinical residents and graduate students, young doctors and professors of the city and Russia.

Having headed the Department of Infectious Diseases at the St. Petersburg Medical Academy of Postgraduate Education, she brought it to the level of leading teams in the field of HIV infection. Its partners were prominent specialists from around the world and international organizations: the UN, WHO, UNESCO, etc.

She achieved the seemingly impossible - she organized an HIV infection and specialist training service before HIV infection came to the North-West region and St. Petersburg, and personally participated in the diagnosis of the first cases of the disease in Russia. She convinced the mayor, and later the governor of St. Petersburg, of the need to create a city AIDS service and for many years was an adviser to the city's top officials on issues of HIV medicine.

Aza Hasanovna took part in the formation of a school of HIV specialists. It included hundreds of infectious disease doctors, therapists, epidemiologists, etc., dozens of clinical residents and interns, graduate students and doctors of science. Today there is not a single city in the Soviet Union where Aza Hasanovna’s students work.

A subtle mind, hard work and natural curiosity allowed her to become the author of the first studies in the field of HIV medicine, the first author and editor of domestic manuals, create the original journal “AIDS, Sex, Health”, support and head the journal “HIV Infection and Immunosuppression” and be for several decades, the main infectious disease specialist in Leningrad - St. Petersburg.

In St. Petersburg, her active energy was aimed at reorganizing the service and opening new units in hospitals and clinics. The pinnacle of her scientific and professional activities is the creation of original international training centers in the field of HIV medicine, the ideology of service development in Russia and neighboring countries, the development of scientific research in the field of infectious pathology, virology and epidemiology.

Aza Hasanovna Rakhmanova published more than 500 scientific papers and trained about a hundred candidates and doctors of science, she was an amazingly active person, a researcher, and devoted her entire life to treating patients and educating people for the benefit of their health.

Rachmaninov Sergei Vasilievich (1873-1943), composer, pianist and conductor.

Born on April 1, 1873 in the Semenov estate in the Novgorod province into a noble family. In 1882, the Rachmaninovs moved to St. Petersburg. That same year, Sergei entered the conservatory.

In the fall of 1886, he became one of the best students and received a scholarship named after A. G. Rubinstein.

At the final exam in harmony, P. I. Tchaikovsky liked the preludes composed by Rachmaninov so much that he gave an “A”, surrounded by four pluses.

The most significant of the early works is the one-act opera “Aleko” based on the plot of A. S. Pushkin. It was completed in an unprecedentedly short time - just over two weeks. The examination took place on May 7, 1892; the commission gave Rachmaninov the highest rating, and he was awarded the Big Gold Medal. The premiere of "Aleko" at the Bolshoi Theater took place on April 27, 1893 and was a huge success.

In the spring of 1899, Rachmaninov completed the famous Second Concerto for Piano and Orchestra; in 1904 the composer was awarded the Glinkin Prize for it.

In 1902, the cantata “Spring” was created based on the poem “Green Noise” by N. A. Nekrasov. For it, the composer also received the Glinkin Prize in 1906.

A significant event in the history of Russian music was the arrival of Rachmaninoff in the fall of 1904 at the Bolshoi Theater to the post of conductor and director of the Russian repertoire. In the same year, the composer completed his operas “The Miserly Knight” and “Francesca da Rimini”. After two seasons, Rachmaninov left the theater and settled first in Italy and then in Dresden.

The symphonic poem “Island of the Dead” was written here. In March 1908, Sergei Vasilyevich became a member of the Moscow Directorate of the Russian Musical Society, and in the fall of 1909, together with A. N. Scriabin and N. K. Medtner, he joined the Council of the Russian Music Publishing House.
At the same time, he created the choral cycles “Liturgy of St. John Chrysostom” and “Vespers”.

In the fall of 1915, Vocalise appeared, dedicated to the singer A.V. Nezhdanova. In total, Rachmaninov wrote about 80 romances.

In 1917, the situation in the country worsened, and the composer, taking advantage of the invitation to tour to Stockholm, went abroad on December 15. He did not imagine that he was leaving Russia forever. After touring Scandinavia, Rachmaninov arrived in New York.

In the summer of 1940, he completed his last major work, “Symphonic Dances.”
On February 5, 1943, the last concert of the great musician took place.

Year of manufacture: 2003

Genre: Infectious diseases

Format: PDF

Quality: OCR

Description: HIV infection was first described in 1981 by the US Centers for Disease Control (CDC) Morbidity and Mortality Weekly Report (MMWR, 1981). This disease was called acquired immunodeficiency syndrome (AIDS), which occurs in sexually active people, injection drug users, and recipients of blood and its products. It was indicated that the disease has the same mode of transmission as viral hepatitis B.
In 1983, human T-cell lymphotropic virus (LAV) was isolated in the laboratory of Luc Montagny at the Pasteur Institute in Paris, and in the same year, T-cell lymphotropic virus type III (HTLV3) was discovered by Robert Gallo and his collaborators. Then it turned out that these viruses are identical. The virus was named human immunodeficiency virus (HIV). This virus belongs to the group of RNA-containing retroviruses that have an enzyme - reverse transcriptase, which ensures the appearance of viral DNA in the genome of cells with damage to macrophages, T4-CD4 + lymphocytes and replication of the virus in the latter. Progressive destruction of the immune system leads to the development of acquired immunodeficiency syndrome (AIDS). Due to the fact that HIV antibodies are present in this disease long before the development of AIDS, the disease has also received another name abroad - HIV disease. It has been established that after seroconversion, a flu-like syndrome can develop, sometimes with clinical signs of encephalitis or aseptic meningitis. People can carry the virus for many years without showing signs of illness. Gradually, the immune system is destroyed by the virus, the number of CO4+ lymphocytes decreases, and the disease progresses.
Currently, the situation in the world with HIV infection, the plague of the 20th century, can be put on a par with two world wars, both in terms of the number of lives lost and the damage it causes to society. “HIV/AIDS is a global problem that has reached catastrophic proportions,” said UN Secretary-General Kofi Annan at an international conference at UN headquarters on June 25, 2001.
Currently, the disease is developing as two epidemics:

1. a horizontal epidemic spreading parenterally (in the vast majority of cases, due to intravenous drug use) and sexually;
2. vertical epidemic, which is characterized by the birth of HIV-infected children from infected mothers.

This problem is given a lot of attention by domestic and foreign researchers [Pokrovsky V.I., 1989-1999; Pokrovsky V.V., 19912000; Khaitov R. M., Ignatieva G. A., 1992; Rakhmanova A.G., 1994, 2000; Lobzin Yu. V. et al., 1998; Ermak T.N., 1999; Levy J., 1989; Cameron W., 1996; Fleming R. et al., 1999; Ho D., 1999; Gazzard V., 1999].
In our country, the first imported cases of HIV infection were identified in the early 80s by V.I. Pokrovsky. Later, the first case of HIV infection in a citizen of the USSR was described in the domestic literature [Pokrovsky V.V. et al., 1987, 1992], and the first case of death from AIDS [Rakhmanova A.G. et al., 1989].
V.V. Pokrovsky identifies several stages in the development of the HIV epidemic in Russia. Until 1988, the disease was registered mainly among foreigners or persons who had sexual contact with foreigners. In 1988-1989 the author characterized nosocomial outbreaks of HIV infection in a number of Russian cities (Elista, Volgograd, Rostov). In 1990-1995 There was a slow increase in the number of HIV-infected people infected through sexual contact, mainly in large cities. Since 1996, an epidemic rise in the incidence of HIV infection among injection drug addicts began [Pokrovsky V.V., 1998]. According to experts, in the coming years the number of HIV-infected people in Russia may reach half a million people or more.
As of December 1, 2001, there were over 40 million people living with HIV in the world (including 5 million infected in 2001), of which 17.6 million were women and 2.7 million were children under 15 years of age. In 2001, 1.1 million women and 580,000 children under the age of 15 died from AIDS. Every year, women with HIV infection give birth to about 600,000 infected children. It is believed that from 62% to 85% of perinatal transmission occurs during childbirth or in the early neonatal period. In children, AIDS is one of the six most common causes of death, and in Africa it is the first (75-80% of children are infected perinatally, about 20% through blood, its preparations and dirty needles).
Comprehensive studies carried out in our country and abroad have obtained data on the clinical characteristics of secondary and opportunistic infections, as well as the results of the use of highly active antiretroviral therapy, mainly in adults [Pokrovsky V. I., 1989; Pokrovsky V.V. et al., 1989-2000; Rakhmanova A. G. et al., 1989-2000; Kravchenko A.V. et al., 1993; Lysenko A. Ya. et al., 1996; Zmushko E.I., 1996, 2000; Shakhgildyan V.N., 1997; Ermak T.N., 1999; Yurin O. G., 1999; Bartlett J., 1997, 2000; Carpenter J. et al., 1996, 2000].
At the same time, many issues of clinical manifestations of the disease in children, antiretroviral therapy regimens, behavioral characteristics of children and caregivers that influence the implementation of such therapy, as well as the organization of medical and social care for children with HIV infection are not sufficiently covered in the literature and need further study [Gorshkova N.V., 1998; Nielsen K., 2000; Autran B. et al., 1997; Krogstad R. et al., 1999]. Works published in the domestic literature on the quality of life of both HIV patients and their relatives are also rare [Ulyukin I.M., 2001].
All of the above served as an incentive to present data from a long-term study (1991-2001) of the clinic of HIV infection and opportunistic diseases in children and to evaluate the effectiveness of various antiretroviral drug regimens in complex therapy of patients based on the results of immunological, serological and molecular biological studies, for improving the system of providing medical and social care for this disease.

"HIV infection in children"

CLINICAL AND EPIDEMIOLOGICAL ASPECTS OF HIV INFECTION IN CHILDREN

1. Epidemiology of HIV infection in children
2. Diagnosis of HIV infection in young children
3. Classifications of HIV infection in children
4. Prognostic criteria for HIV infection in children
5. Clinic and treatment of HIV infection and opportunistic diseases in children

CLINICAL CHARACTERISTICS OF DIFFERENT STAGES OF HIV INFECTION IN CHILDREN

1. Characteristics of examined children with HIV infection
2. Basic research methods and statistical processing of material
   1. Clinical assessment of patients' condition
   2. Laboratory, instrumental examination and statistical processing of material
3. Clinical characteristics of different stages of HIV infection in children
4. Pathology of the central nervous system and behavioral reactions in children with HIV infection
5. Damage to the nervous system due to HIV infection in children

RESULTS OF ANTIRETROVIRAL THERAPY IN CHILDREN WITH NOSOCOMIAL HIV INFECTION

1. Results of monotherapy
2. Antiretroviral therapy regimens for examined children with HIV infection
3. Determination of viral load in children with HIV infection
4. Combination antiretroviral therapy
5. Combination antiretroviral therapy using two reverse transcriptase inhibitors
6. Antiretroviral triple-drug combination therapy
7. Results of combination therapy in children with CD4-lymphocyte levels less than 0.2x109/l
8. Results of combination therapy in children with CB4-lymphocyte levels more than 0.2x109/l
9. Determination of HIV resistance to antiretroviral therapy
10. Identification of mutations in the HIV-1 genome associated with resistance to antiretroviral drugs
11. Clinical examples characterizing the success and failure of antiretroviral therapy in children with HIV infection

QUALITY OF LIFE OF CHILDREN WITH NOSOCOMIAL HIV INFECTION AND THEIR MOTHERS
MEDICAL AND SOCIAL ASSISTANCE FOR CHILDREN WITH NOSOCOMIAL HIV INFECTION

1. Study of the psychological state of patients and people from their immediate environment
2. Peculiarities of behavior of children with HIV infection
3. Peculiarities of behavior of mothers of children with HIV infection
4. The relationship between adherence to treatment regimen and psychological and behavioral characteristics of children with HIV infection and people from their immediate environment
5. Improving the provision of medical and social care to children with nosocomial HIV infection

ORGANIZATION OF MEDICAL AND SOCIAL ASSISTANCE FOR CHILDREN WITH PERINATAL HIV INFECTION

1. PCR diagnosis of HIV infection in children born to HIV-infected mothers
2. Clinical manifestations of HIV infection in young children
3. Clinical and immunological indicators, indications for antiretroviral therapy and its assessment in abandoned HIV-infected children born to HIV-positive mothers
4. Clinical examples of diagnosis and treatment of HIV infection in young children
5. Ways to organize medical and social care for children with perinatal HIV infection

Bibliography